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Arterial ulcer

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https://www.readbyqxmd.com/read/28211296/recommendations-for-the-medical-management-of-chronic-venous-disease-the-role-of-micronized-purified-flavanoid-fraction-mpff
#1
Ronald Bush, Anthony Comerota, Mark Meissner, Joseph D Raffetto, Steven R Hahn, Katherine Freeman
Scope A systematic review of the clinical literature concerning medical management of chronic venous disease with the venoactive therapy Micronized Purified Flavonoid Fraction was conducted in addition to an investigation of the hemodynamics and mechanism of chronic venous disease. Methods The systematic review of the literature focused on the use of Micronized Purified Flavonoid Fraction (diosmin) which has recently become available in the US, in the management of chronic venous disease. The primary goal was to assess the level of evidence of the role of Micronized Purified Flavonoid Fraction in the healing of ulcers, and secondarily on the improvement of the symptoms of chronic venous disease such as edema...
April 2017: Phlebology
https://www.readbyqxmd.com/read/28195823/clinical-safety-of-bariatric-arterial-embolization-preliminary-results-of-the-beat-obesity-trial
#2
Clifford R Weiss, Olaguoke Akinwande, Kaylan Paudel, Lawrence J Cheskin, Brian Holly, Kelvin Hong, Aaron M Fischman, Rahul S Patel, Eun J Shin, Kimberley E Steele, Timothy H Moran, Kristen Kaiser, Amie Park, David M Shade, Dara L Kraitchman, Aravind Arepally
Purpose To conduct a pilot prospective clinical trial to evaluate the feasibility, safety, and short-term efficacy of bariatric embolization, a recently developed endovascular procedure for the treatment of obesity, in patients with severe obesity. Materials and Methods This is an institutional review board- and U.S. Food and Drug Administration-approved prospective physician-initiated investigational device exemption study. This phase of the study ran from June 2, 2014, to August 4, 2015. Five severely obese patients (four women, one man) who were 31-49 years of age and who had a mean body mass index of 43...
January 17, 2017: Radiology
https://www.readbyqxmd.com/read/28194903/vitamin-k-antagonist-therapy-is-a-risk-factor-for-ulcer-development-and-death-among-dialyzed-patients
#3
Andreana De Mauri, Massimo Torreggiani, Marco Brambilla, Doriana Chiarinotti
Peripheral artery disease is a common complication among dialyzed patients. Since Vitamin K antagonists promote metastatic calcifications and these are the main determinants of vascular damage, we investigated their role in the development of lower limb ulcers in dialyzed patients. We retrospectively enrolled 316 dialyzed patients, aged 68 ± 15 years, 65% male, 32% diabetic, 43% with ischemic heart disease and followed them for 36 ± 25 months. 60 patients assumed Vitamin K antagonists: they were older, with a higher prevalence of heart disease, at greater risk of death and they developed more ulcers and underwent more lower limb amputations compared to the rest of our cohort...
February 14, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28194322/sural-artery-perforator-flap-with-posterior-tibial-neurovascular-decompression-for-recurrent-foot-ulcer-in-leprosy-patients
#4
Hossam El-Din Ali Ismail, Mohamed Hassan El Fahar
Introduction: The sensory loss and alteration of the shape of the foot make the foot liable to trauma and pressure, and subsequently cause more callus formation, blisters, and ulcers. Foot ulcers usually are liable to secondary infection as cellulitis or osteomyelitis, and may result in amputations. Foot ulcers are a major problem and a major cause of handicaps in leprosy patients. The current study is to present our clinical experience and evaluate the use of sural flap with posterior tibial neurovascular decompression (PTND) in recurrent foot ulcers in leprosy patients...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/28188368/complications-in-hepatic-arterial-infusion-chemotherapy-retrospective-comparison-of-catheter-tip-placement-in-the-right-left-hepatic-artery-vs-the-gastroduodenal-artery
#5
Rinpei Imamine, Toshiya Shibata, Ken Shinozuka, Kaori Togashi
PURPOSE: To compare the complication rates associated with hepatic arterial infusion chemotherapy (HAIC) for unresectable hepatocellular carcinoma (HCC) using two different catheter tip locations, the right/left hepatic artery (group 1) and the gastroduodenal artery (group 2). METHODS: Between April 2001 and March 2015, 88 patients (group 1, n = 36; group 2, n = 52) with unresectable HCC, underwent HAIC via a transfemorally placed infusion catheter. The incidence of complications related to catheter placement (including hepatic arterial occlusion, catheter dislocation, non-target embolization and port-catheter system infection) as well as catheter patency and patient survival were evaluated...
February 10, 2017: Surgery Today
https://www.readbyqxmd.com/read/28184958/bariatric-arterial-embolization-with-non-spherical-polyvinyl-alcohol-particles-for-ghrelin-suppression-in-a-swine-model
#6
Jae Min Kim, Man-Deuk Kim, Kichang Han, Lailatul Muqmiroh, Seung Up Kim, Gyoung Min Kim, Joonho Kwon, Sung Il Park, Jong Yun Won, Do Yun Lee
PURPOSE: To evaluate the effect of bariatric arterial embolization (BAE) with non-spherical polyvinyl alcohol (PVA) particles on systemic ghrelin levels, weight change, and gastric ulceration risk in a swine model. MATERIALS AND METHODS: From March 2014 to February 2015, ten healthy swine were used in the study (mean weight 31.5 kg; range 24.0-41.5 kg). The animals were randomly assigned to two groups: the embolized group (n = 5) in which BAE was performed and the control group (n = 5)...
February 9, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28182532/healing-of-an-arterial-leg-ulcer-by-compression-bandaging-a-case-report
#7
C Sanchez, H Partsch
This case report demonstrates that arterial ulcers may heal with compression therapy. The patient was a 72-year-old woman with elevated blood pressure and type II diabetes mellitus, who underwent angiography because of a painful, non-healing ulcer over the shin. The angiography showed multisegment arterial occlusive disease, not amenable to surgical revascularisation. After 4 months of wearing inelastic bandages, with increased pressure over the ulcer area and hypertension and diabetes under control, the patient was pain-free and the ulcer had healed...
February 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28167214/doppler-endoscopic-probe-monitoring-of-blood-flow-improves-risk-stratification-and-outcomes-of-patients-with-severe-non-variceal-upper-gastrointestinal-hemorrhage
#8
Dennis M Jensen, Thomas Og Kovacs, Gordon V Ohning, Kevin Ghassemi, Gustavo A Machicado, Gareth S Dulai, Alireza Sedarat, Rome Jutabha, Jeffrey Gornbein
BACKGROUND & AIMS: For 4 decades, stigmata of recent hemorrhages in patients with non-variceal lesions have been used for risk stratification and endoscopic hemostasis. The arterial blood flow that underlies the stigmata is rarely monitored, but can be used to determine risk for rebleeding. We performed a randomized controlled trial to determine whether Doppler endoscopic probe monitoring of blood flow improves risk stratification and outcomes in patients with severe non-variceal upper gastrointestinal hemorrhage...
February 3, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28166662/-ischemic-origin-of-diabetic-foot-disease-epidemiology-difficulties-of-diagnosis-options-for-prevention-and-revascularization
#9
Endre Kolossváry, Zoltán Bánsághi, Gábor Viktor Szabó, Zoltán Járai, Katalin Farkas
"Diabetic foot" as definition covers a multifactorial clinical condition. According to the recent epidemiological data, the role of lower limb ischemia is getting more influential over other pathological causes, like neuropathy, infections and bone or soft tissue deformity. In diabetes, vascular disease leads to increased risk for leg ulcers and minor or major amputations. The traditional diagnostic tools for recognition of peripheral arterial disease have limited value because of diabetes specific clinical manifestations...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28165057/a-novel-indication-of-platonin-a-therapeutic-immunomodulating-medicine-on-neuroprotection-against-ischemic-stroke-in-mice
#10
Joen-Rong Sheu, Zhih-Cherng Chen, Thanasekaran Jayakumar, Duen-Suey Chou, Ting-Lin Yen, Hsing-Ni Lee, Szu-Han Pan, Chih-Hsuan Hsia, Chih-Hao Yang, Cheng-Ying Hsieh
Thrombosis and stroke are major causes of disability and death worldwide. However, the regular antithrombotic drugs may have unsatisfactory results and side effects. Platonin, a cyanine photosensitizing dye, has been used to treat trauma, ulcers and some acute inflammation. Here, we explored the neuroprotective effects of platonin against middle cerebral artery occlusion (MCAO)-induced ischemic stroke in mice. Platonin(200 μg/kg) substantially reduced cerebral infarct volume, brain edema, neuronal cell death and neurological deficit scores, and improved the MCAO-reduced locomotor activity and rotarod performance...
February 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28164133/the-geriatric-nutritional-risk-index-independently-predicts-mortality-in-diabetic-foot-ulcers-patients-undergoing-amputations
#11
Yuanyuan Xie, Hailing Zhang, Tingting Ye, Shengjie Ge, Ruyi Zhuo, Hong Zhu
Objective. Patients with diabetic foot ulcers undergoing amputations have poor prognosis. Malnutrition usually occurs in this population and is associated with increased risk of mortality. The geriatric nutritional risk index (GNRI) is a widely used, simple, and well-established tool to assess nutritional risk. The purpose of this study was to assess the association between GNRI and all-cause mortality in diabetic foot ulcers patients undergoing minor or major amputations. Methods. This was a retrospective cohort study including 271 adult patients...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28153676/a-model-to-estimate-cost-savings-in-diabetic-foot-ulcer-prevention-efforts
#12
Neal R Barshes, Samira Saedi, James Wrobel, Panos Kougias, O Erhun Kundakcioglu, David G Armstrong
BACKGROUND: Sustained efforts at preventing diabetic foot ulcers (DFUs) and subsequent leg amputations are sporadic in most health care systems despite the high costs associated with such complications. We sought to estimate effectiveness targets at which cost-savings (i.e. improved health outcomes at decreased total costs) might occur. METHODS: A Markov model with probabilistic sensitivity analyses was used to simulate the five-year survival, incidence of foot complications, and total health care costs in a hypothetical population of 100,000 people with diabetes...
January 21, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28151868/impact-of-betablockers-on-general-and-local-outcome-in-patients-hospitalized-for-lower-extremity-peripheral-artery-disease-the-copart-registry
#13
Tristan Mirault, Alexandre Galloula, Jean-Pierre Cambou, Philippe Lacroix, Victor Aboyans, Carine Boulon, Joel Constans, Alessandra Bura-Riviere, Emmanuel Messas
Lower extremity peripheral artery disease (PAD) is one manifestation of atherosclerosis. Patients with PAD have an increased rate of mortality due to concurrent coronary artery disease and hypertension. Betablockers (BB) may, therefore, be prescribed, especially in case of heart failure. However, BB safety in PAD is controversial, because of presumed peripheral hemodynamic consequences of BB that could lead to worsening of symptoms in patients with PAD. In this context, we aimed to determine the impact of BB on all-cause and cardiovascular mortality and amputation rate at 1 year after hospitalization for PAD from the COPART Registry population...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28149549/calcification-of-arteries-supplying-the-gastric-tube-increases-the-risk-of-anastomotic-leakage-after-esophagectomy-with-cervical-anastomosis
#14
Liang Zhao, Gefei Zhao, Jiagen Li, Bin Qu, Susheng Shi, Xiaoli Feng, Hao Feng, Jun Jiang, Qi Xue, Jie He
BACKGROUND: Anastomotic leak is an important cause of morbidity and mortality after esophagectomy for esophageal cancer patients. Calcification of the arteries supplying the gastric tube has been found to be associated with leakage after esophagectomy with cervical anastomosis in Europeans. The purpose of this study is to evaluate the association between calcifications of the supplying arteries of the gastric tube and the occurrence of anastomotic leakage after esophagectomy with cervical anastomosis in Chinese patients with esophageal cancer...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28143739/phase-ib-safety-two-dose-study-of-multigeneangio-in-patients-with-chronic-critical-limb-ischemia
#15
Moshe Y Flugelman, Moshe Halak, Boris Yoffe, Jacob Schneiderman, Chen Rubinstein, Allan-Isaac Bloom, Eran Weinmann, Ilya Goldin, Victor Ginzburg, Olga Mayzler, Aaron Hoffman, Belly Koren, Diana Gershtein, Michal Inbar, Marina Hutoran, Adili Tsaba
Critical limb ischemia (CLI) is the most severe presentation of peripheral arterial disease. We developed cell-based therapy entailing intra-arterial injection of autologous venous endothelial cells (ECs) modified to express angiopoietin 1, combined with autologous venous smooth muscle cells (SMCs) modified to express vascular endothelial growth factor. This combination promoted arteriogenesis in animal models and was safe in patients with limiting claudication. In an open-label, phase Ib study, we assessed the safety and efficacy of this therapy in CLI patients who failed or were unsuitable for surgery or intravascular intervention...
January 28, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28138903/the-treatment-of-giant-cell-arteritis
#16
REVIEW
Imran Jivraj, Madhura Tamhankar
Giant cell arteritis (GCA) is a systemic inflammatory vasculitis affecting medium and large vessels with potentially sight and life-threatening complications. Early diagnosis and prompt treatment are imperative in order to prevent vision loss and progression of the disease. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are inflammatory markers which are elevated in the majority of patients and support the diagnosis of GCA among patients who present with typical symptoms. GCA is confirmed with superficial temporal artery biopsy which demonstrates characteristic pathological findings...
January 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28133924/safety-and-efficacy-of-intramuscular-human-placenta-derived-mesenchymal-stromal-like-cells-cenplacel-pda-002-in-patients-who-have-a-diabetic-foot-ulcer-with-peripheral-arterial-disease
#17
Stephanie C Wu, Richard Pollak, Robert G Frykberg, Wei Zhou, Maha Karnoub, Vladimir Jankovic, Steven A Fischkoff, Denesh Chitkara
The objective of this study was to examine the safety of cenplacel (PDA-002) in patients with peripheral arterial disease (PAD) and a diabetic foot ulcer (DFU). Cenplacel is a mesenchymal-like cell population derived from full-term human placenta. This phase 1, dose-escalation study investigated cenplacel in diabetic patients with chronic DFUs (Wagner grade 1 or grade 2) and PAD [ankle-brachial index (ABI) >0·5 and ≤0·9], enrolled sequentially into each of four dose cohorts (3 × 10(6) , 10 × 10(6) , 30 × 10(6) and 100 × 10(6) cells; administered intramuscularly on study days 1 and 8 in combination with standard of care)...
January 30, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28133234/-a-case-of-primary-sclerosing-cholangitis-difficult-to-distinguish-from-a-hilar-cholangiocarcinoma
#18
Yutaka Umehara, Minoru Umehara, Shinji Tsutsumi, Akitoshi Kimura, Tomohisa Tokura, Kenichi Takahashi, Takayuki Morita
A 78-year-old man, who had presented with onset of ulcerative colitis at the age of 56 years and had been in remission for the past several years, attended our hospital with a diagnosis of obstructive jaundice. A hilar cholangiocarcinoma with right hepatic artery invasion was suspected on contrast enhanced CT. An endoscopic retrograde cholangiography indicated Bismuth type 2 stenosis. The stenotic bile duct brushings revealed no malignancy. Primary sclerosing cholangitis(PSC)and IgG4- related cholangitis were included in the differential diagnosis; however, a significant result could not be obtained in any other examinations...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28130285/migrating-coil
#19
Kai Rou Tey, Avin Aggarwal, Bhaskar Banerjee
We describe a rare case of a 60-year-old man with known history of peptic ulcer disease who presented with melena and epigastric pain secondary to coil migration into duodenal mucosa 4 years after the initial therapeutic embolisation of the gastroduodenal artery. Upper endoscopy revealed oozing duodenal ulcer at the same site of the previously located duodenal ulcer 4 years ago and metal coil impacted at the duodenal mucosa. It is unclear if the coil migration is the effect or the cause of the bleeding duodenal ulcer...
January 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28127215/use-of-short-term-steroids-in-the-prophylaxis-of-atrial-fibrillation-after-cardiac-surgery
#20
Zeyad Al-Shawabkeh, Khalid Al-Nawaesah, Razi Abu Anzeh, Hael Al-Odwan, Wasfi Azyoud Bashar Al-Rawashdeh, Haetham Altaani
OBJECTIVES: To assess the effectiveness of corticosteroids in the prophylaxis of postoperative atrial fibrillation (AF) in patients undergoing elective coronary artery bypass grafting or valvular heart surgery in terms of reducing its incidence and decreasing the length of hospital stay. METHODS: This prospective double blinded randomized study was conducted at Queen Alia Heart Institute (Amman, Jordan) from June 2014 to June 2015 on 340 patients who underwent their first on-pump elective coronary artery bypass grafting (CABG) alone or combined with valvular surgery...
January 2017: Journal of the Saudi Heart Association
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